Open and closed rhinoplasty are two main approaches to perform nasal modifications. According to current literature, there is no current consensus among plastic surgeons and otolaryngologists on which technique is preferred in terms of aesthetic result, complications, and patient satisfaction. This study uses published research to determine whether open or closed rhinoplasty leads to superior patient outcomes. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews were followed and a literature search was conducted in four databases based on our search strategy. Articles were then imported into COVIDENCE where they underwent primary screening and full-text review. Twenty articles were selected in this study after 243 articles were screened. There were 4 case series, 12 retrospective cohort studies, 1 prospective cohort study, 1 case-control, and 2 outcomes research. There were three cosmetic studies, eight functional studies, and nine studies that included both cosmetic and functional components. Sixteen studies utilized both open and closed rhinoplasty and four utilized open rhinoplasty. Both techniques demonstrated high patient and provider satisfaction and no advantage was found between techniques. Based on available studies, we cannot conclude if there is a preference between open or closed rhinoplasty in terms of which technique leads to better patient outcomes. Several studies determined that open rhinoplasty and closed rhinoplasty leads to comparative patient satisfaction. To make outcome reporting more reliable and uniform among studies, authors should look to utilize the Nasal Obstruction and Septoplasty Effectiveness scale and the Rhinoplasty Outcome Evaluation.
Korea Health Panel (KHP) data and Korea National Health and Nutrition Examination Survey (KNHANES) data are collected by self-assess and self-report for individual's health status and medical use. Previous studies have claimed that the reliability for prevalence rates and health life expectancies obtained from these data should be validated. National Health Insurance Services in Korea recently released a sample cohort DB that contain all data related to the use of medical facilities for all entire Korea citizens. It has been shown that disease-specific prevalence rates calculated from these data are representative and reliable for the entire population. In this paper, we evaluate the reliability of prevalence rates derived from self-reported data such as KHP and KNHANES by comparing to the prevalence rates from the sample cohort DB. We found that both KHP and KNHANES underestimate prevalence rates and in turn overestimate health life expectancies. Moreover, the general trends of health life expectancies might be distorted (except for the sample cohort DB) because of sampling and non-sampling errors.
As a number of people using the internet for their shopping steadily rises, it is increasingly important for retailers to understand why consumers decide to buy products via online or offline. The main purpose of this study is to develop and test a model that enhance our understanding of how consumers respond future online and offline channels for their purchasing. Rather than merely adopting statistical models like most other studies in this field, the present study develops a model that combines double-cohort method with multinomial logit model. It is desirable if one can adopt an overall encompassing criterion in the study of consumer behaviors form diverse sales channels. This study uses the concept of cohort or aging to enable this comparison. It enables us to analyze how consumers respond to online and offline channels as people aged by measuring their shopping behavior for an online and offline retailers and their subsequent purchase intentions. Based on some empirical findings, this study concludes with policy implications and some necessary fields of future studies desirable.
We investigated the leaf demography of a temperate woody liana, Akebia trifoliata, in a temperate forest in Japan, Akebia is semi-evergreen: some leaves are shed before winter, while others remain through the winter. Previous studies of semi-evergreen species found that variation in leaf life span was caused by variation in the timing of leaf emergence, Leaves that appeared just before winter over-wintered, while leaves appearing earlier were shed, However, it is unclear whether leaves of the same cohort (i.e., leaves that appear at the same time within a single site) show variation in life span under the effect of strong seasonality. To separate variation in life span among the leaves in each cohort from variation among cohorts, we propose a new method - the single leaf diagram, which shows the emergence and death of each leaf. Using single leaf diagrams, our study revealed that Akebia leaves within a cohort showed substantial variation in life span, with some over-wintering and some not. In addition, leaves on small ramets in the understory showed great variation in life span, while leaves on large ramets, which typically reach higher positions in the forest canopy, have shorter lives, As a result, small ramets were semi-evergreen, whereas large ramets were deciduous, The longer lives of leaves on small ramets can be interpreted as a shade-adaptive strategy in understory plants.
Background: Previous studies on the association of oral contraceptives (OC) use and lung cancer generated inconsistent findings. The aim of this study was to confirm any definite correlation between OC use and lung cancer risk. Methods: Publications were reviewed and obtained through PubMed and EMBASE databases literature search up to November, 2013. Reference lists from retrieved articles were also reviewed. The language of publication was restricted to English. A meta-analysis was performed to evaluate the association by calculating pooled odds ratios (ORs) and 95% confidence intervals (CIs). Results: A total of 14 studies consisting of 9 case-control studies and 5 cohort studies were finally included in this meta-analysis. There was no significant association observed between OC use and lung cancer risk in the overall analysis (OR=0.91; 95% CI=0.81-1.03). There was a significant protective effect in Europe (OR=0.74; 95% CI=0.60-0.91) and a borderline significant protective effect with an adenocarcinoma histology (OR=0.90; 95% CI=0.80-1.01) in subgroup analyses. No association was observed for methodological quality of study, study design, smoking status and case number of study. Conclusion: This meta-analysis suggests that OC use is not likely to be associated with the risk of lung cancer at all. While a significant protective effect of OC use on lung cancer was observed in Europe, interpretation should be cautious because of the potential biases of low-quality studies. At the same time, more attention should be paid to the possible association of OC use with adenocarcinoma of lung. Our findings require further research, with well-conducted and large-scale epidemiological studies to confirm effects of OC use on lung cancer.
Background: Prospective cohort studies to determine cofactors with oncogenic HPV-infections for cervical cancer are very rare from developing countries and such data are limited to the few screening trials. Large screening trials provide such data as a by product. Some of the cases are prevented by screening and do not surface as invasive cancers at all. Also, pre-invasive lesions are detected almost entirely by screening. Screening causes selection bias if attendance in or effectiveness of screening is correlated with the risk factors. The aim of this study was to quantify the influence of screening on risk factors for cervical cancer. Materials and Methods: Our material stems from a rural cohort of 80,000 women subjected to a randomised screening trial. The effect of screening on the incidence of cervix cancer was estimated with reference to socio-demographic and reproductive risk factors of cervical cancer. We compared these risks with the incidence of cancer in the randomised control population by the same determinants of risk. Results: The results in the screening arm compared to the control arm showed that the women of low SES and young age were benefitting more than those of high SES and old age. The relative risk by age (30-39 vs 50-59) was 0.33 in the control arm and 0.24 in the screening arm. The relative risk by education (not educated vs educated) was 2.8 in the control arm and 1.8 in the screening arm. The previously married women did not benefit (incidence 113 and 115 per 100,000 women years in control vs screening arms) whereas the effect was substantial in those married (86 vs 54). Conclusions: The results in controls were consistent with the general evidence, but results in attenders and nonattenders of the screening arm showed that screening itself and self-selection in attendance and effectiveness can influence the effect estimates of risk factors. The effect of cervical cancer screening programmes on the estimates of incidence of cervical cancer causes bias in the studies on etiology and, therefore, they should be interpreted with caution.
Ko, Young-Jin;Kim, Ji Young;Lee, Joongyub;Song, Hong-Ji;Kim, Ju-Young;Choi, Nam-Kyong;Park, Byung-Joo
Journal of Preventive Medicine and Public Health
/
v.47
no.1
/
pp.36-46
/
2014
Objectives: To evaluate the association between fracture risk and levothyroxine use in elderly women with hypothyroidism, according to previous osteoporosis history. Methods: We conducted a cohort study from the Korean Health Insurance Review and Assessment Service claims database from January 2005 to June 2006. The study population comprised women aged ${\geq}65$ years who had been diagnosed with hypothyroidism and prescribed levothyroxine monotherapy. We excluded patients who met any of the following criteria: previous fracture history, hyperthyroidism, thyroid cancer, or pituitary disorder; low levothyroxine adherence; or a follow-up period <90 days. We categorized the daily levothyroxine doses into 4 groups: ${\leq}50{\mu}g/d$, 51 to $100{\mu}g/d$, 101 to $150{\mu}g/d$, and > $150{\mu}g/d$. The hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated with the Cox proportional hazard model, and subgroup analyses were performed according to the osteoporosis history and osteoporosis-specific drug prescription status. Results: Among 11 155 cohort participants, 35.6% had previous histories of osteoporosis. The adjusted HR of fracture for the > $150{\mu}g/d$ group, compared with the 51 to $100{\mu}g/d$ group, was 1.56 (95% CI, 1.03 to 2.37) in osteoporosis subgroup. In the highly probable osteoporosis subgroup, restricted to patients who were concurrently prescribed osteoporosis-specific drugs, the adjusted HR of fracture for the > $150{\mu}g/d$ group, compared with the 51 to 100 ${\mu}g/d$ group, was 1.93 (95% CI, 1.14 to 3.26). Conclusions: While further studies are needed, physicians should be concerned about potential levothyroxine overtreatment in elderly osteoporosis patients.
Cheon, Jeong Hyun;Lee, Hyung Chul;Im, Gi Jung;Park, Jung Youl;Park, Chul
Archives of Plastic Surgery
/
v.46
no.6
/
pp.525-534
/
2019
Background In microtia patients with bilateral hearing impairment, hearing improvement is crucial for language development and performance. External auditory canal reconstruction (EACR) has been performed to improve hearing, but often results in complications. We performed transcutaneous bone conduction implant (TBCI) surgery in these patients. This study aimed to evaluate the safety and efficacy of TBCI surgery. Methods A retrospective review was performed of five patients who underwent auricular reconstruction and TBCI surgery and 12 patients who underwent EACR between March 2007 and August 2018. Hearing improvement was measured based on the air-bone gap values using pure-tone audiometry over a 6-week postoperative period. We reviewed other studies on hearing improvement using EACR and compared the findings with our results. The surgical techniques for TBCI were reviewed through case analyses. Results Postoperative hearing outcomes showed a significant improvement, with a mean gain of 34.1 dB in the TBCI cohort and 14.1 dB in the EACR cohort. Both gains were statistically significant; however, the TBCI cohort showed much larger gains. Only three of the 12 patients who underwent EACR achieved hearing gains of more than 20 dB, which is consistent with previous studies. All patients who underwent TBCI surgery demonstrated hearing gains of more than 20 dB and experienced no device-related complications. Conclusions TBCI is a safe and effective method of promoting hearing gains in microtia patients with bilateral hearing impairment. TBCI surgery provided better hearing outcomes than EACR and could be performed along with various auricular reconstruction techniques using virgin mastoid skin.
Recent cohort studies have relied on exposure prediction models to estimate individual-level air pollution concentrations because individual air pollution measurements are not available for cohort locations. For such prediction models, geographic variables related to pollution sources are important inputs. We demonstrated the computation process of geographic variables mostly recorded in 2010 at regulatory air pollution monitoring sites in South Korea. On the basis of previous studies, we finalized a list of 313 geographic variables related to air pollution sources in eight categories including traffic, demographic characteristics, land use, transportation facilities, physical geography, emissions, vegetation, and altitude. We then obtained data from different sources such as the Statistics Geographic Information Service and Korean Transport Database. After integrating all available data to a single database by matching coordinate systems and converting non-spatial data to spatial data, we computed geographic variables at 294 regulatory monitoring sites in South Korea. The data integration and variable computation were performed by using ArcGIS version 10.2 (ESRI Inc., Redlands, CA, USA). For traffic, we computed the distances to the nearest roads and the sums of road lengths within different sizes of circular buffers. In addition, we calculated the numbers of residents, households, housing buildings, companies, and employees within the buffers. The percentages of areas for different types of land use compared to total areas were calculated within the buffers. For transportation facilities and physical geography, we computed the distances to the closest public transportation depots and the boundary lines. The vegetation index and altitude were estimated at a given location by using satellite data. The summary statistics of geographic variables in Seoul across monitoring sites showed different patterns between urban background and urban roadside sites. This study provided practical knowledge on the computation process of geographic variables in South Korea, which will improve air pollution prediction models and contribute to subsequent health analyses.
Purpose: This prospective cohort study was done to investigate recall bias to antepartum variables measured at postpartum periods and predictors of postpartum depression. Methods: Participants were 215 women who answered a self-administered questionnaire which included demographics, Postpartum Depression Predictors Inventory-Revised and Korean version of Edinburgh Postpartum Depression Scale at antepartum 36-40 weeks and postpartum 2 weeks and 6 weeks. Data were analyzed using kappa, and hierarchical multiple logistic regression. Results: Agreement between antepartum variables at both antepartum and two postpartum periods was relatively high (${\kappa}$=.55- .95). Postpartum depression rates were 36.3% and 36.7% at two follow-up points. In hierarchical multiple logistic regression analysis, prenatal depression (OR=4.32, 95% CI: 1.41-13.19; OR=5.19, 95% CI: 1.41-19.08), social support (OR=1.40, 95% CI: 1.18-1.66; OR=1.27, 95% CI: 1.06-1.53) and maternity blues (OR=4.75, 95% CI: 1.89-11.98; OR=4.22, 95% CI: 1.60-11.12) were commonly associated with postpartum depression at two follow-up points. Child care stress (OR=1.85, 95% CI: 1.01-3.37) was only associated with postpartum depression at 2 weeks postpartum and pregnancy intendedness (OR=1.57, 95% CI: 1.09-2.27) was only associated with postpartum depression at 6 weeks postpartum. Conclusions: The results indicate a need to apply nursing interventions such as prenatal education and counseling with families from antenatal period.
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